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36-119 (3) T s' •a T. x#ji of Narthun ptor DEPARTMENT OF BUILDIXG INSPECTIONS q INSPECTOR 212 Main Street ' Municipal Building Northampton, Mass. 01060 SOLID FUEL BURNING APPLIANCE & CHIMNEY APPLICATION PERMIT NUMBER bdq Page J& Plotj� Zone 4(jG4. Location d Owner or Lessee a e Mailing Addr s) Tele. No. Contractor 4A jffd4AM4 as (Name) (Address) (Tele. No. ) RESIDENTIAL N4.RESIDENTIAL f�One family Home Business Two or More Other Number of Units Specify Stories in Building Type of Appliance je�ew Aellood burning Used Coal Labeled Combination_ Date of Purchase Other (� Specify Model or Type Manufacturer VLJ Purchased From (Name of Firm) (Address) Cost - Construction & Appliance $ _j ao 0 Chimney New Metal Bestos Existing Interior chimney Separate Flue Exterior chimney Other appliance attached to flue Masonary Lined Unlined Notes & Data: Signature of Applicant: [[pp W� , (Address) Approved By: 944450E &-4--= Title: �' `� ` Date: ` �� w i a DEPT. OF BUILDING INSPECTIONS gU1LDING ZD- �� ��� 212 Main Street < Northampton, MA 01060 PERMIT 40 VALIDATION 36 119 Sept. 29, 88 629 DATE 19 7 MI NO- APPLICANT Raymond Leary ADDRESS �ks �ir.Owner (N0.) (STREET) (LDNTR'S LICENSE) One Family Wood Burning �tovp STORY OWELLRNG UNITS PERMIT TO (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) XXAKNXX 240 Brookside Cir. ZONING URA AT (LOCATION) DISTRICT (N0.) (STREET) BETWEEN AND . (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: permit for the installation of a wood burning stove AREA OR $' 2,000.00 PER $ ESTIMATED COST 10.00 VOLUME (CUBIC/SQUARE FEET) OWNER Same as Applicant IL 6! 0 ADDRESS Same as Applicant BY WHITE - FILE COPY . GREEN - FIELD COPY • CANARY - APPLICANT COPY • PINK - ASSESSORS COPY ONIP